Shared Care

A traffic light system, the RAG List, defines the responsibility for prescribing and monitoring medicines between primary care and specialists.

When clinical and/or prescribing responsibility for a patient is transferred from specialists to the GP, the GP should have full confidence to prescribe the necessary medicines. Therefore it is essential that transfers of care involving medicines should not take place without the sharing of information with the individual GP and their mutual agreement to the transfer of care.These are not rigid guidelines, GPs and specialists may agree to work outside these guidelines if a discussion to agree this has taken place.

RAG List

RAG List June18

If you receive a request to prescribe in the absence of a shared care guideline, which you consider inappropriate please complete a Hospital Prescribing Reporting Form.

RED: Prescribing remains the responsibility of the specialist and the hospital pharmacy should arrange supply of the medicine.

AMBER: With the GPs agreement, prescribing can be transferred at an appropriate time from the specialist to the GP but there continues to be shared involvement in monitoring and managing treatment.

GREEN: Suitable for initiation by GPs or initiation on the recommendation of a specialist. 
  

Pan Mersey APC have a slightly different catorgisation of medicines. Please see the Pan Mersey APC website for further information.

During the merger process the formulary will be reviewed on a chapter by chapter basis and the Pan Mersey APC categorisation adopted for each reviewed chapter. 

Shared Care Protocols

Safe management of medicines for patients requires clearly defined responsibilities between the GP and the specialist for monitoring and managing treatment. 

For Cheshire & Wirral Partnership NHS Foundation Trust guidelines & policies relating to mental health, please visit: www.cwp.nhs.uk/resources/policies 

Drug Indication Comments
Apomorphine Injection Idiopathic Parkinson’s Disease  
Atomoxetine ADHD in Children and Adolescents  
Auranofin Rheumatoid arthritis and other rheumatological conditions  
Azathioprine Dermatology conditions  
Azathioprine Rheumatoid arthritis and other rheumatological conditions  
Azathioprine and 6-mercaptopurine Inflammatory bowel disease under review 
Ciclosporin Dermatology  
Ciclosporin Rheumatoid arthritis and other rheumatological conditions  
Colistimethate (nebulised) Bronchiectasis  
Donepezil Treatment of mild/moderate Alzheimer's disease  under review
DMARD Monitoring Summary

 

 
Fosfomycin (oral) Urinary Tract Infection (Adults)  
Galantamine Treatment of mild/moderate Alzheimer's disease  under review

Gonadorelin analogue and gonadotrophin-releasing hormone (GnRH) antagonists

Prostate cancer
 
Gonadorelins Endometriosis and uterine fibroids  
Hydroxycarbamide Psoriasis in adults  
Hydroxychloroquine Rheumatoid arthritis and other rheumatological conditions  
Leflunomide Rheumatoid arthritis and other rheumatological conditions  
Lisdexamphetamine ADHD in children and adolescents  
Lisdexamfetamine in Adults ADHD in adults  
Melatonin Sleep disorders in children and adolescents  
Memantine Treatment of moderate/severe Alzheimer's disease under review 
Mesalazine and other aminosalicylates Inflammation Bowel Disease (adults)  
Methotrexate Crohn’s Disease  
Methotrexate Psoriasis and other dermatological conditions  
Methotrexate (subcutaneous injection) Rheumatoid arthritis and other inflammatory diseases  
Methotrexate tablets Asthma and sarcoidosis  
Methotrexate tablets Rheumatoid arthritis and other rheumatological conditions  
Methylphenidate ADHD in Children and Adolescents  
Metolazone for CKD For Chronic Kidney Disease (Adults)  
Metolazone for Refractory Heart Failure (Adults)     
Mycophenolate Rheumatoid arthritis and other rheumatological conditions  
Mycophenolate Pemphigus and other dermatological diseases  
Penicillamine Rheumatoid arthritis and other rheumatological conditions  
Rasagiline Parkinson's disease  
Rotigotine Parkinson's disease  
Rivastigmine Treatment of mild/moderate Alzheimer's disease  under review
Rivastigmine (oral) Treatment of dementia in patients with Parkinson’s disease  
Sodium Aurothiomalate (I.M) Rheumatoid arthritis and other rheumatological conditions  
Sodium Chloride Oral supplement for neonates and children    
Stiripentol Shared Care Guideline Dravet Syndrome in Children and Adolescents shared care guideline
Sulfasalazine Rheumatoid arthritis and other rheumatological conditions  

Please Note: Documents which are past their review date will only remain on the website if they are still clinically relevant.